Provider Demographics
NPI:1669497715
Name:HILL, LESA (PA-C)
Entity Type:Individual
Prefix:
First Name:LESA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70368
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-0120
Mailing Address - Country:US
Mailing Address - Phone:541-683-1559
Mailing Address - Fax:541-683-1709
Practice Address - Street 1:590 COUNTRY CLUB PKWY
Practice Address - Street 2:STE A
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6025
Practice Address - Country:US
Practice Address - Phone:541-683-1559
Practice Address - Fax:541-683-1709
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01073363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical